Because patient retention and adherence to protocol will be a major emphasis in this project, we intend to use a 3 session "run-in" prior to randomization. Patients who appear to be medically eligible, meet study criteria for major depression, and who express willingness to participate return for a session in which the patient completes a medical history form, undergoes a brief physical exam, takes a maximum exercise stress test, is given a standardized dietary assessment, and is taught how to use a food diary and activity monitor. At the beginning of the third run-in session, the patient returns the completed food diary, and data from the activity monitor is recorded. The patient then takes a 2 hour oral glucose tolerance test (OGTT) during which time he or she answers questions about health habits, psychosocial functioning and health quality of life. After a brief rest and snack the patient is escorted to the Ultrasound Laboratory for assessment of echocardiography, carotid artery imaging and brachial artery endothelial functioning. Patients who satisfactorily complete all three run-in sessions, meet eligibility requirements and are interested in participating, are then asked to provide informed consent and are randomized into the CALM-D or SC conditions.